Pivoting After an ACL Tear: Sierra’s Story
Pivoting After an ACL Tear: Sierra’s Story
Reviewed by Joseph L. Yellin, MD
Reviewed on
As captain of both her school soccer team and the nationally ranked Penn Fusion ECNL team, 16-year-old Sierra lives and breathes the game. So, when a serious injury took her off the field, it felt like her world had stopped. But with the support of her care team in the Sports Medicine and Performance Center here at Children’s Hospital of Philadelphia (CHOP), her family and her teammates, Sierra found her way back — stronger than ever.
A life built around the game
Before her injury, Sierra’s life revolved around soccer. “I go to boarding school, so my days were basically school and then soccer, every single day,” she says. “All I did was play.”
Sierra and her team’s hard work paid off. Penn Fusion is ranked number three in the country, and in June of 2024, Sierra was preparing for a major showcase where college coaches would be watching. “I was really focused on showing my skills,” she says.
The moment everything changed
Then, during a game, another player collided with Sierra and she fell awkwardly. “It was really uncomfortable,” she remembers. “A teammate’s mom, who’s a physical therapist, checked me out and thought my knee might be okay, but told me to get it looked at.”
A few days later, Sierra tried to play in a scrimmage but couldn’t cut or pivot. Her knee swelled, and she knew something was wrong. An MRI confirmed what she’d feared: she had torn her anterior cruciate ligament (ACL), an injury that would require surgery. “It was crushing,” she says. “I was supposed to go to nationals a week later. I’d worked so hard for that moment.”
Finding the right ACL repair team at CHOP
Sierra’s parents scheduled an appointment for her at CHOP with Joseph L. Yellin, MD, an orthopedic surgeon in our Orthopedic Center and our Sports Medicine and Performance Center. He specializes in sports injuries. “When I met Dr. Yellin, he explained everything really clearly: what my surgery would involve, what the recovery would look like and what I could expect, step by step,” Sierra says.
Dr. Yellin also talked about the importance of not rushing recovery after an ACL tear. “He told me there’s a real chance of re-tearing your ACL if you try to come back too fast,” Sierra says. “Everyone at CHOP wanted to make sure I healed fully.”
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ACL surgery and the long road back
Sierra had ACL reconstruction surgery on July 9, 2024. “It was my first surgery, so I was nervous,” she says. “But everyone was so nice; they made me feel calm.”
Sierra’s injury was a complete ACL tear (a grade three injury). During surgery, Dr. Yellin and his team carefully took a small section from the center of Sierra's tendon between the thigh and kneecap (quadriceps tendon) and reinforced it with sturdy stitches. Then, they guided it through small tunnels made in her thigh and shin bones and secured it tightly with button-like anchors on each side (suspensory fixation) so it could heal in the right position.
This technique is called a quadriceps tendon autograft, and it has several benefits:
- It uses the patient’s own tendon to help the knee move the way it’s supposed to, and it can become just as strong — or even stronger — than the original ACL.
- It uses a small incision and doesn’t weaken the hamstring muscles, which help protect the ACL. It also lowers the chance of pain in the front of the knee later as compared to other autograft options.
- It protects the soft areas of developing bone near the ends of long bones (growth plates) in young adults who are still growing; and it offers excellent stability for teens who have finished growing.
Mental hurdles and small wins during ACL rehab
Just two weeks later, Sierra started physical therapy (PT) at our Specialty Care, King of Prussia location. “At first, it was so hard,” she admits of her ACL rehab. “Just learning how to walk without limping and trying to keep my leg straight was tough.”
Her therapist, Jacqueline Braun, PT, DPT, CSCS, quickly became one of her biggest supporters. “Jackie always had a smile on her face. She gave me the quote, ‘good things take time,’ which really stuck with me,” Sierra says. “She told me I was one of the hardest-working patients she’d had. Jackie had a big impact on my recovery.”
The hardest part of recovery from her ACL injury wasn’t just physical, it was mental. “Watching my teammates play while I couldn’t was really hard,” Sierra says. “Soccer is such a big part of my identity. It felt like I’d lost a part of myself.”
But Sierra found motivation in small milestones. “When I could finally run again, I thought, ‘Okay, I can do this,’” she says. “I didn’t do great on my first practice test and left PT crying. But when I retook it, I nailed it — and that’s when I knew I’d make it back.”
Jackie remembers, “Sierra always came with a positive attitude. She rose to any challenge ACL rehab put in front of her; she viewed every new obstacle as a way to challenge herself mentally and physically to be a better athlete.”
Sierra’s teammates, who she also lives with at school, were a huge source of encouragement. “They got me a necklace that says ‘strong,’ and I wear it every day,” she says. “They were always there, and they knew when to build me up.”
Back where she belongs
Exactly nine months after surgery — on April 9, 2025 — Sierra was cleared to return to the field. “The first time I played again was unreal,” she says. “I wasn’t worried about my knee. I was just so grateful to be back.”
Dr. Yellin and Jackie noticed how hard Sierra worked toward recovery. Dr. Yellin shared, "I am honestly so proud of Sierra and her recovery journey. She is a dedicated, extremely hardworking, elite level athlete, and our whole team was thrilled to hear she successfully passed all her strength and functional testing at the nine-month post-operative mark, allowing her to begin her return to sport protocol. It's no small feat, but we had no doubt Sierra would do it!"
Jackie says, “She does not take for granted her ability to return to playing on the field at the same ability level. Being out for a prolonged period of time definitely opened her eyes to be thankful for what her body can do.”
Sierra is easing back into competition, wearing her brace for support, and focusing on rebuilding strength. This past summer, she helped lead her team to the Elite Eight again — and this time, she scored the goal that sent them to the Final Four!
Finding purpose beyond the field
Even though Sierra is back on the field, the experience changed her perspective. “It’s hard sitting out sometimes as a leader and captain,” she says. “I had to learn how to help my team in different ways.”
She’s also started thinking about her future in soccer and beyond. One day she wants to be a physician assistant (PA) in sports medicine so she can help other athletes with similar injuries. And she’s already begun her journey to help. Sierra started an Instagram account documenting her ACL recovery. She has felt that having the Instagram account is a good log of her progress because it shows examples of when she has hit various milestones along her recovery.
“Other people can look at those milestones and have hope,” says Sierra. “I wanted to show other athletes they’re not alone.”
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